That night at 10, I literally sleep-walked home - a distance of about half a kilometer from the hospital. I had not slept more than three hours in three nights. Those three days, I was not a physician busy treating patients; but a relative of a young patient - himself a young doctor - as he breathed his last on a ventilator. I had been outside the ICU waiting for three days.
That was in 1985. I had been a doctor for nine years at a large teaching hospital in Mumbai, India – a hospital that catered to those from the lower socio economic strata of society. This heart-wrenching episode completely changed my view of patient care. I realised what it was to be on the other side and all that my medical teachers had said about “true caring for the patient” began to make new sense.
Sometimes, unusual circumstances result in dramatic changes in one’s life. I met Radha Ramaswamy, the Founder of CCDC at a school reunion. During a chance conversation with Radha,I realised the potential of Theatre of the Oppressed to improve physician-patient interactions . Now, the use of Theatre of the Oppressed in medical education, as a part of a growing field of knowledge called Medical Humanities, is becoming a sub specialty of CCDC’s Theatre of the Oppressed practice.
Dr. Ravi Ramakantan - Team, CCDC.
In a broad sense, the term Medical Humanities is a field that integrates the 'Art of Humaneness’ and the 'Science of Medicine'.
Over the last century and, especially over the last couple of decades, the sophistication of diagnostic
and therapeutic medical equipment and procedures and an increasingly litigant society has led to a situation where the patient-physician relationship has eroded to one of a client and a caregiver, resulting in what is often referred to as commoditization of healthcare. As a result, the truth that health and ill health are about human beings, their bodies and minds, and about how they affect patients, their immediate family and the society they live in, is lost sight of. Patients and their relatives are left wondering if, today, “the well-being of the patient” is indeed the first concern of physicians - as it ought to be.
In medical circles, this phenomenon has been long recognised and bemoaned. In an attempt to remedy the situation, many universities and medical schools and colleges offer courses that teach ‘communication skills and ethics’ to medical students.
Unfortunately, such ad-hoc solutions offer neither a quick fix nor a foundation-forming solution to
the problem. In order that trust and a strong relationship between the physician and the patient be
established, it is not only necessary to promote greater understanding between the doctor and the patient but also provide enabling solutions where all stakeholders see themselves as a part of the larger society we all live in. Improvement in communication and hence greater caring will likely occur automatically if both the lay society and the physician community develop understanding about themselves. This awareness of oneself and one’s relationship to the society we live is one aspect of human personality and continued development that Theatre of the Oppressed techniques enable.
Though the use of Theatre of the Oppressed is not entirely new in setting of medical practice, most times, its use has been restricted to Forum Theatre performances by non-medical people for a medical audience and, in mental health situations.
Our aim, however, is to work on a larger canvas – starting from medical student education to student –faculty relationships in medical school and of course in the field of patient care both in a hospital and community setting.
It was against this backdrop that when Mr. Marc Weinblatt, the Founder of the Mandala Center for Change in Seattle, Washington visited India, he was requested to conduct a six -day facilitator training workshop in Mumbai in January 2010. About 30 medical professionals including medical students, faculty in medical schools and paramedical professionals attended this six-day facilitator workshop.
Spurred by the positive feedback from this event and also based on the subsequent experiences of the participants in Forum Theatre in the community, CCDC has decided that one of its areas of focus will be workshops on the application of Theatre of the Oppressed techniques in the whole field of medical education and medical care. Based on data from these workshops, the feedback and follow up results, CCDC plans to research the usefulness of Theatre of the Oppressed techniques in the Medical Humanities.
To begin with, our founder Radha Ramaswamy, will conduct the initial series of workshops, with a
view to train, as quickly as possible, a batch of interested medical and allied professionals to be facilitators for subsequent workshops.
As a part of this program, in September 2011, Radha conducted a two-day workshop in theatre of the oppressed culminating in a Forum performance at the University College of Medical Sciences in New Delhi, India. This was the the first time that a Theatre of the Oppressed workshop was being conducted exclusively for medical students. The workshop and the benefits it had to offer were received with great enthusiasm.
Seeing the usefulness of such workshops in the medical context, Radha has since conducted other
workshops in Mumbai (Seth GS Medical College and KEM Hospital); Vellore (Christian Medical College) and Manipal (Kasturba Medical College) and at KIST Medical College at Kathmandu, Nepal.
After participating in a recent Theatre of the Oppressed workshop facilitated by Radha, a senior medical teacher of Medical Humanities had this to say. " Theatre of the Oppressed techniques will lead to better understanding of oneself. This will eventually translate into better faculty-student rapport and improved doctor-patient communication". He opined that Theatre of the Oppressed workshops should be a part of Medical Humanities programs and all medical students and interested faculty should participate in it.
You can see the Feedback from participants at these workshops at these links:
If you are interested in attending a six-day Facilitator Training Workshop in Theatre of the Oppressed in June 2012, in Bengaluru, India, please see this link.
If you want to explore the possibility for a Theatre of the Oppressed Workshop in your Medical Institution, please contact us .
We are sure, we will learn valuable lessons from these initial workshops and, over a period of time, be able to crystallize our thoughts on the utility of this medium in medical education and patient care.
However, given the novelty of this activity and the magnitude of the task, it is apparent that we have a long haul ahead of us. We, therefore, welcome professionals from all over the world who have ideas and suggestions or have had experience in this area to contact us with details.